Gonorrhea is one of the most dangerous sexually transmitted infections.

Gonorrhea is considered one of the most dangerous sexually transmitted infections. In the absence of adequate and timely treatment, gonorrhea can provoke the development of infertility. The prevalence of the disease is very high, with more than 200 million people annually diagnosed with gonorrhea infection. The genitourinary system is predominantly affected, with the development of a characteristic clinical picture. Gonorrhea requires careful attention to the selection of an adequate treatment regimen, due to the likelihood of the pathogen developing resistance to certain types of antibiotics.

The etiological factor in the development of gonorrhea is gonococcus

The causative agent of gonorrheal infection – gonococcus, is a rounded gram-negative diplococcus located in the cytoplasm of cells. Gonococcus can exist for a long time in a purulent environment, but dies under the influence of high temperatures, when dried or exposed to direct rays. Therefore, the main mechanism of transmission is sexual contact, and the presence of a large number of unprotected relationships is a high risk factor for infection with gonorrhea. Gonococcus is a highly contagious pathogen that settles in the thickness of the columnar epithelium of the genitourinary system, but sometimes it can enter the bloodstream and provoke a generalization of the infection or its atypical manifestations – gonococcal endocarditis, meningitis, arthritis. The duration of the incubation period for gonorrhea infection is from 3 days to a month.

Classification of gonorrhea infection: main types

Sexual infections, which include gonorrhea, are very common in the practice of gynecologists and urologists. This group of diseases, in the absence of timely and effective treatment, can lead to serious consequences.

The classification of gonorrhea is based on the localization of the pathogenic action of the pathogen. In ICD-10, the following types of gonorrheal infection are distinguished:

• gonococcal infection of the lower genitourinary regions without glandular abscesses;
• gonococcal infection of the lower genitourinary regions with gland abscesses;
• gonococcal pelvioperitonitis and lesions of other organs of the genitourinary system;
• gonococcal eye infection;
• gonococcal pharyngitis;
• gonococcal arthritis;
• gonococcal proctitis;
• other gonococcal infections.

Clinical presentation of gonorrhea: characteristic symptoms

The earliest and most characteristic manifestations of gonorrhea of ​​the lower genitourinary system are purulent or purulent-sanitary discharge of a yellow-green color.

They provoke a burning sensation and itching in the vagina and external genital organs, when viewed, a characteristic sign is swelling and redness of the urethral orifice. Over time, dysuric manifestations and pain during urination may join. If the infection moves to the upper parts of the genitourinary system, the patient complains of fever, severe pain in the lower abdomen, urination and defecation disorders, nausea and vomiting. Chronic gonorrheal infection provokes menstrual irregularities and the formation of adhesions in the pelvis, which ultimately leads to infertility. In the case of a different localization of gonorrheal infection, a clinical picture characteristic of this inflammatory process appears.

Laboratory and instrumental methods for diagnosing gonorrhea

The main methods for detecting gonorrhea pathogens are bacterioscopic and bacteriological laboratory methods. After drying the taken material, the preparation is stained according to Gram and under a microscope, a picture characteristic of gonococcus is visualized – Gram-negative paired cocci located intracellularly. With the help of bacteriological culture, it is possible not only to confirm the diagnosis of gonorrhea by detecting the growth of pathogenic gonococcal microflora, but also to determine the sensitivity of the pathogen to antibacterial drugs.  With the help of ultrasound, you can get information about the state of the internal organs of the reproductive system, metrosalpingography allows you to determine the development of the adhesive process in the cavity of the fallopian tubes.

Basic Treatments for Gonorrheal Infection

Treatment of gonorrhea is carried out with the help of antibiotic therapy, the obligatory moment of which is the preliminary determination of the individual resistance of the pathogen to antibiotics.

The drugs of choice are third-generation cephalosporins and fluoroquinolones, but it is important to remember that the latter are contraindicated in pregnant and lactating women, as well as children under 14 years of age. Immunomodulators are also prescribed to increase the body's ability to fight infection. For local therapy, instillations into the urethra and vagina of solutions of silver preparations are used. The treatment regimen is selected strictly individually. It is important to notify the patient that all partners with whom he had sexual contact during the last month should undergo examination and treatment. The criteria for a complete cure for gonorrheal infection is the disappearance of all symptoms of the disease, and the absence of gonococcus in the body according to the results of laboratory tests, not earlier than 10 days after the completion of treatment.